Sexual and Urinary Outcomes After iTind for Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis

To characterize urinary and sexual outcomes following temporary implantable nitinol devices (iTind; Olympus, Japan) therapy for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) through a systematic review and single-arm meta-analysis.

PubMed, Embase, and Cochrane Central databases were queried for prospective studies of men with LUTS/BPH treated with iTind. Primary outcomes were change-from-baseline in the International Prostate Symptom Score (IPSS), IPSS quality-of-life (IPSS-QoL), maximum urinary flow rate (Qmax), post-void residual volume (PVR), and Sexual Health Inventory for Men (SHIM/IIEF-5) score. Ejaculatory function was also assessed. Pooled random-effects meta-analysis was performed.

Five prospective studies (431 patients) were included. 12-month pooled change-from-baseline results: IPSS was -10.44 points (95% CI -11.79 to -9.09; k = 4, I2 = 74%). IPSS-QoL was -2.08 points (95% CI -2.22 to -1.93; k = 4, I2 = 0%). Qmax was +5.38 mL/s (95% CI +3.25 to +7.51; k = 4, I2 = 93%). PVR was -12.21 mL (95% CI -24.27 to -0.16; k = 3, I2 = 77%). Two studies (n = 198) reported SHIM/IIEF-5 scores; Pooled analysis at 1 and 3 months was +0.68 points (95% CI -1.54 to +2.90; k = 2, I2 = 75%) and +1.19 points (95% CI -1.42 to +3.80; k = 2, I2 = 82%), respectively, indicating no statistically significant change in erectile function. Ejaculatory function was preserved, with no de novo retrograde ejaculation. 12-month surgical reintervention rates ranged from 0% to 4.7%.

iTind produces consistent, clinically meaningful improvements in urinary outcomes through 12 months. Ejaculatory function was preserved in all studies, and erectile function showed no significant change. Comparative trials with validated sexual function instruments are warranted.